Relationship between health-related quality of life domains and bone status in postmenopausal Japanese women

Objective: To assess the relationship between health-related quality of life domains and bone status, including bone metabolism, in postmenopausal Japanese community women. Design: The study subjects were 88 women who were participants in a screening program for osteoporosis in 2003 without a history of mental disorders, metabolic disorders, smoking, bone fractures, and/or estrogen treatment. The participation rate was 75.9%. The age range was 50 to 68 years (mean, 57), and body mass index (BMI) ranged from 15.7 to 36.6 (mean, 22.4). Health-related quality of life domains were evaluated using the Medical Outcomes Study Short-Form 36 Health Survey, and bone mineral content was measured by quantitative ultrasound of the calcaneus. Serum total osteocalcin and serum N-telopeptide were measured by enzyme-linked immunosorbent assay. Multiple linear regression models were used to study the association of age, BMI, and eight health-related quality of life domains as independent variables in age-corrected bone status and markers of bone turnover as dependent ones. Results: The participants' calcaneal Z scores by quantitative ultrasound ranged from -2.14 to 2.71. The mean Z score was -0.17 (-0.27,-0.07). Multiple regression analysis revealed that BMI (P < 0.05), physical function (P < 0.01), and role-emotional (role limitations caused by emotional problems) (P < 0.01) were factors in increasing bone mineral content. Also, a positive relationship was found between vitality (P < 0.01), social function (P < 0.05), and total osteocalcin. Conclusions: Although causality is not clear, in addition to low BMI, role limitations due to poor emotional status and low physical function are related to low bone mineral content in postmenopausal Japanese community women. These results imply that when we are concerned about osteoporosis in postmenopausal women, we should pay attention not only to their physical function but also to their psychological state.